NIH Consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. The 2014 Pathology Working Group Report

Biol Blood Marrow Transplant. 2015 Apr;21(4):589-603. doi: 10.1016/j.bbmt.2014.12.031. Epub 2015 Jan 29.


The 2005 National Institute of Health (NIH) Consensus Conference outlined histopathological diagnostic criteria for the major organ systems affected by both acute and chronic graft-versus-host disease (GVHD). The 2014 Consensus Conference led to this updated document with new information from histopathological studies of GVHD in the gut, liver, skin, and oral mucosa and an expanded discussion of GVHD in the lungs and kidneys. The recommendations for final histological diagnostic categories have been simplified from 4 categories to 3: no GVHD, possible GVHD, and likely GVHD, based on better reproducibility achieved by combining the previous categories of "consistent with GVHD" and "definite GVHD" into the single category of "likely GVHD." Issues remain in the histopathological characterization of GVHD, particularly with respect to the threshold of histological changes required for diagnostic certainty. Guidance is provided for the incorporation of biopsy information into prospective clinical studies of GVHD, particularly with respect to biomarker validation.

Keywords: Allogeneic hematopoietic cell transplantation; Chronic graft-versus-host disease; Consensus; Diagnosis; Histology; Pathology.

Publication types

  • Consensus Development Conference, NIH
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Biomarkers / metabolism
  • Clinical Trials as Topic*
  • Female
  • Graft vs Host Disease* / metabolism
  • Graft vs Host Disease* / pathology
  • Humans
  • Intestinal Diseases* / metabolism
  • Intestinal Diseases* / pathology
  • Liver Diseases* / metabolism
  • Liver Diseases* / pathology
  • Male
  • Mouth Diseases* / metabolism
  • Mouth Diseases* / pathology
  • Skin Diseases* / metabolism
  • Skin Diseases* / pathology


  • Biomarkers